Breathing intolerance index in healthy infants

Hasegawa, Hisaya; Henmi, Nobuhide; Tsuruta, Shio; Miyoshi, Yoshitaka; Yamada, Yousuke; Muto, Junichi; Wasa, Masanori

doi:10.1111/ped.12247

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…The long examination time causes respiratory muscle fatigue, and the increase in the amount of ventilation demanded by the ventilatory response of the respiratory center cannot be generated, which may result in an underestimation of the VRCO 2 . Hasegawa et al 11 demonstrated that the tolerance for respiratory load in infants was lower than in adults, and respiratory muscle fatigue was more likely to occur in infants. We think that the short examination time is one of important characteristics of the rebreathing method in infants.…”

Section: Discussionmentioning

confidence: 99%

Ventilatory response to CO₂ with Read's rebreathing method in normal infants

Yamada

Henmi

Hasegawa

et al. 2021

Pediatric Pulmonology

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Background Methods of evaluating the ventilatory response to CO2 (VRCO2) of the respiratory center include the steady‐state and the rebreathing method. Although the rebreathing method can evaluate the ventilatory response continuously to gradually increasing CO2, the rebreathing method has been rarely performed in infants. The aim of this study was to investigate whether we could perform the VRCO2 with the rebreathing method in normal infants. Methods The subjects were 80 normal infants. The gestational age was 39.9 (39.3–40.3) weeks, and the birth body weight was 3142 (2851–3451) grams. We performed the VRCO2 with Read's rebreathing method, measuring the increase in minute volume (MV) in response to the increase in EtCO2 by rebreathing a closed circuit. The value of VRCO2 was calculated as follow: VRCO2 (ml/min/mmHg/kg) = ΔMV/ΔEtCO2/body weight. Results We performed the examination without adverse events. The age in days at examination was 3 (2–4), and the examination time was 150 ± 38 s. The maximum EtCO2 was 51.1 (50.5–51.9) mmHg. The value of VRCO2 was 34.6 (29.3–42.8). The intraclass correlation coefficient of the VRCO2 of cases with multiple measurements was 0.79. Conclusion This study suggests that the rebreathing method can evaluate the ventilatory response to high blood CO2 in a short examination time. We conclude that the rebreathing method is useful even in infants. In the future, we plan to measure the VRCO2 of preterm infants, and evaluate the respiratory center of infants in more detail.

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Section: Discussionmentioning

confidence: 99%

Ventilatory response to CO₂ with Read's rebreathing method in normal infants

Yamada

Henmi

Hasegawa

et al. 2021

Pediatric Pulmonology

Self Cite

View full text Add to dashboard Cite

show abstract

“…The long examination time causes respiratory muscle fatigue, and the increase in the amount of ventilation demanded by the ventilatory response of the respiratory center cannot be generated, which may result in an underestimation of the VRCO 2 . Hasegawa et al demonstrated that the tolerance for respiratory load in infants was lower than in adults, and respiratory muscle fatigue was more likely to occur in infants 9) . We think that the short examination time is one of the advantages of the rebreathing method in infants.…”

Section: Discussionmentioning

confidence: 99%

Ventilatory response to CO2 with Read's rebreathing method in normal infants

Yamada¹,

Henmi²,

Hasegawa³

et al. 2020

Preprint

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Background Methods of evaluating the ventilatory response to CO2 (VRCO2) of the respiratory center include the steady-state and the rebreathing method. Although the rebreathing method can evaluate the respiratory center more in detail, the steady-state method has been mainly performed in infants. The aim of this study was to investigate whether we could perform the VRCO2 with the rebreathing method in normal infants. Methods The subjects were 80 normal infants. The gestational age was 39.9（39.3-40.3）weeks, and the birth body weight was 3,142 (2,851-3,451) grams. We performed the VRCO2 with Read’s rebreathing method, measuring the increase in minute volume (MV) in response to the increase in EtCO2 by rebreathing a closed circuit. The value of VRCO2 was calculated as follow: VRCO2 (mL/min/mmHg/kg) = ΔMV / ΔEtCO2 / Body weight. Results We performed the examination without adverse events. The age in days at examination was 3 (2-4), and the examination time was 150±38 seconds. The maximum EtCO2 was 51.1 (50.5-51.9) mmHg. The value of VRCO2 was 34.6 (29.3-42.8). Tidal volume had a greater effect on the increase in MV than respiratory rate (5.4 to 14.3 mL/kg, 44.1 to 55.9 /min, respectively). Conclusion This study suggests that the rebreathing method can evaluate the ventilatory response to high blood CO2 in a short examination time. We conclude that the rebreathing method is useful even in infants. In the future, we plan to measure the VRCO2 of preterm infants, and evaluate the respiratory center of infants in more detail.

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Examination of changes in the breathing intolerance index to determine the respiratory support needs of very low birth weight infants

Mizogami,

Hasegawa,

Yamada

et al. 2024

Pediatric Pulmonology

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BackgroundThe breathing intolerance index (BITI) is used to evaluate respiratory muscle tolerance. The higher the ratio of the inspiratory time to the total breathing time and the ratio of the tidal volume to the vital capacity, the more easily the respiratory muscles become fatigued. The BITI is high with chronic respiratory failure, and values of 0.15 or more indicate the need for assisted ventilation.ObjectiveThis study aimed to examine the changes in the BITI of very low birth weight infants (VLBWIs) and determine whether it is possible to use the BITI as an objective indicator of the timing of noninvasive respiratory support (NRS) withdrawal.MethodsVLBWIs admitted to our neonatal intensive care unit between July 2020 and July 2022 under NRS at 36 weeks’ postmenstrual age (PMA). If the BITI was less than 0.15, then we attempted to determine whether NRS could be withdrawn.ResultsSixteen infants with a median gestational age and birth weight of 30.9 weeks and 1249 g, respectively, were eligible. The median PMA at the time of the first examination was 36.6 weeks. The BITI of two VLBWIs was less than 0.15. For 11 of the other VLBWIs, the BITI decreased over time to less than 0.15 at 39 weeks’ PMA. After confirming that the BITI was less than 0.15, weaning from NRS was attempted. Weaning from NRS was possible except one VLBWI.ConclusionThe BITI can help evaluate respiratory tolerance and could be an objective indicator of the timing of NRS withdrawal.

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Breathing intolerance index in healthy infants

Abstract: BITI was measured in healthy infants. Further evaluation is needed to determine the significance and usefulness of BITI.

Cited by 3 publications

References 5 publications

Ventilatory response to CO₂ with Read's rebreathing method in normal infants

Ventilatory response to CO₂ with Read's rebreathing method in normal infants

Ventilatory response to CO2 with Read's rebreathing method in normal infants

Examination of changes in the breathing intolerance index to determine the respiratory support needs of very low birth weight infants

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